Full Episode Transcript

Matt :                                  00:09                    Today’s episode of the Pro-Fit podcast. We have a special guest, Patrick McKeown talking to us about an aspect of our health. The all of us quiet frankly should probably be taking much more attention and care with when it comes to making sure that we optimize this part of our lifestyle. And when I say the word to you, you will probably have a little snigger to yourself cause it sounds like something really simple. But today, myself and Patrick McKeown are going to talk about the subject of breathing and making sure that your breathing efficiency leads you down the route of promoting optimal health, optimal performance, and optimal recovery. This may not be something that you think is overly serious when you first think about it, but by the end of this interview, I guarantee that your socks will have been blown off by Patrick and just how much of an important part of our health and wellness this actually is. And when you listen to some of the statistics that he’s got to share with you and some of the improvements that he seen with the people he’s worked with, you’ll see why that this is something that he’s now dedicating his work to and helping people like myself and other professionals spread this message of getting people to just breathe correctly and make sure that they are using this to get the most from their health and wellness. So without further ado, let’s dive right in and hand over to Patrick

Matt:                                   01:32                    As I have just mentioned in the introduction today on the podcast. We have Patrick McKeown from the oxygen advantage. Patrick, how are you doing? Good man. How are you? I’m very, very good. Thank you, we’re very excited to have you here today because I think as we’ve just talked about before we hit record, you talk and teach people about something that is ridiculously important that none of us really ever consider. So I’m interested in unpacking that today. Before we go into some of that Patrick, can you give us an idea of how you actually got into the field of studying and teaching, breathing and understanding just how important this was and how poorly we generally are with this?

Patrick:                               02:09                    Sure. 20 years ago I came across breathing. I came across breathing, not your typical breathing techniques that were being taught at the time. You know all about taking big breaths and full breaths and all of disbelief that the more air you breathe, the more you increase oxygen delivery to the cells. Which by the way is a load of nonsense. Breathing is not breathing, you know, many people teach breathing, but we have to consider the basic breakdown of what’s involved. Some of my story is simple, I poor health a chronic asthma, I had a stuffy nose and I was a constant mouth breather for 20 years. It messed up my academics, it messed up my concentration, my sleep and agitation of the mind and that’s ultimately what it boils down to. If you, we know that a lot of children are mouth breathing and studies are short on between 25 and 50% we know that quite a few adults are mouth breathing, but nobody’s really bothered students studies because most medical doctors were considered a breathing is breathing and it doesn’t matter which hole you breathe through, but it makes a massive difference.

Patrick:                               03:17                    So I think it’s really time for the medical community to wake up. You know, this is normal medical physiology, human beings, we’re born breathing through our nose, our ancestors breathe it through their nose for hundreds of thousands of years and probably in the last 50 years and most certainly in the last 20/30 years, we’ve really started an epidemic of mouth breathing. And the first thing I’ll say is anybody who wakes up with a dry mouth in the morning, they are not waking up feeling alert. You cannot wake up feeling alert if you’re constantly breathing through and open mouth during sleep and also physical exercise. I call it the stupidity of mouth breathing during physical exercise. And I know you personal trainer’s, are going to be saying who is that idiot there? What’s he talking about? Well, that’s what we’re going to support over the next few minutes. So I’ll have to support what I’m saying there. So I’m not not an idiot.

Matt :                                  04:18                    Well, the, you know, the, the journey that you, you’ve been on for 20 years there initially, uh, Patrick was actually quite similar to me. I was misdiagnosed with asthma for years and just by chance I changed GP and he sat me in a chair and just told me to sit still for a minute while he wrote some notes. And after a minute he turned to me and he said, Matt, you haven’t got asthma you just breathe through your mouth. You just breathe wrong. Did I tell you one thing that was an enlightened yeah, yeah. luckily, Enlightened GP, luckily at, you know, that was a relatively early age. I was probably about 12 at the time or something. And that opened my eyes to, uh, this idea of, you know, there was a, there was a right and a wrong way to breathe. Yeah. Did I, did I stick to all these advice initially? Probably not, but I use some of the stuff you talk about now and.

Patrick:                               05:02                    Matt, it’s not just as simple as telling somebody to breathe through the nose. You really have to change behaviour. Like if I’m working, my kids or adults coming in. We spent quite a few hours making that change and it’s not just about switching to nasal breathing, it’s breathing to optimize breathing efficiency to increase oxygen uptake and oxygen delivery. And that can be done through the breath. So there’s a little bit to it, but when you break it down, it’s a, it’s interesting stuff.

Matt :                                  05:29                    So let’s unpack some of the mechanics behind this then Patrick, to give the listeners an understanding of why is there such a stark difference between nasal breathing and mouth breathing and the impact that then has on various aspects of health and the way we live our lives. Talks was about the mechanics behind that and why that difference exists.

Patrick:                               05:47                    The first, first basic difference is oxygen uptake, an oxygen delivery to the cells. People talk about breathing in oxygen and getting rid of carbon dioxide. So the more air you breathe in, the more oxygen you bring into your lungs into the blood. That’s the premise of it and get rid of as much carbon dioxide as possible cause it’s a waste gas. But here’s the thing. In 1904 a Danish biochemist discovered what’s now called the bohr effect BOHR. And he said that the carbon dioxide, the pressure in the blood is very important. When there’s an increase of carbon dioxide in the blood pH drops from the blood to the cells in the presence of carbon dioxide. Now if we’re breathing in hard, we’re also breathing out hard we’re getting rid of too much carbon dioxide. So we’re lowering CO2 in the blood, this in turn is causing blood vessels to constrict.

Patrick:                               06:41                    And this in turn is increasing the bond between hemoglobin and oxygen. So in a nutshell, the harder you breathe, the less oxygen gets delivered to the cells. Now how many times have we heard take full big breaths, breath more air? It’s not good advice. It’s like somebody who is eating enough foods, telling them to eat more because food is good. Yeah, air is good too. But there’s a certain amount we need to breathe, not too much, not too little, just like food, just like water. We can overdo it to a border as well. I suppose. I’m more interested in the chronic breathing patterns of individuals and we know that this can affect certain sectors of the population, but up to 50% of the athlete population can have breathing pattern disorders. Now what that means is that the typical thing that they will experience is increased breathlessness so you can screen for breathing pattern disorders using breath total time.

Patrick:                               07:43                    We use the bolt’s score , so relationship between your bolt score and your breathing patterns and your breathing patterns and your functional movement. You cannot have functional movement unless you have functional breathing. So the bolt score is you take a normal breath in and out through your nose. You pinch your nose with your fingers, your time it in seconds. How long does it take until you feel the first involuntary urge to breathe? If you’re less than 25 seconds, it’s indicative of a breathing pattern disorder. If you’re greater than 25 seconds, it’s indicative of functional breathing. If you’re bolt scored as above 25 seconds and you have functional breathing, you’re also more likely to pass the functional movement. And if you pass functional movements, you’ve got reduced risk of injury. So people are talking about core strength doing this, doing that. You can’t do this without breathing.

Patrick:                               08:40                    You can’t do this without looking at the bio mechanics of breathing, because the diaphragm breathing muscle is not just for respiration. When you take a breath of air into your lungs, it’s driven on the basis of your diaphragm moving down by about one to two centimetres. But as your diaphragm moves downwards, it generates the intraabdominal pressure and this caused the stabilization of the spine. So when one is lifting weights or whether one is running or any sort of physical exercise, you need postural control. You need spinal stabilization and your breathing is important for Nash. Now, if you look at some athletes, look at how do they breathe during rest, you’ll see fast upper chest breathing. It’s not good. These guys are going to run out of air. They’re going to gas out too soon, so I was talking about an athlete.

Patrick:                               09:29                    If you see an athlete and press conference and if you see a guy breathing too fast and using his upper chest, the one prediction that I’m going to make as regardless of who he is or she is, they’re going to gas out too soon and no matter how hard they train, they plateau. If you breathe fast and shallow, you’re not optimizing ventilation because what you’re doing is you’re exchanging a lot of air generally through the mouth and it’s remaining and dead space. It’s remaining in the trobes. It’s remaining the trachea the bronchi, the bronchioles, but it’s not getting it to the small little air SACS the alveoli we breathe for gas exchange to take place and fast shallow breathing through an open mouth is absolutely, totally inefficient. If you think of the human lungs, the structure of the lungs is that the greatest concentration of blood is in the lower lobes.

Patrick:                               10:21                    But if we’re breathing through the mouth, we’re, we’re bringing more air into the upper lobes. So there’s an inefficient gas exchange taking place. So nasal breathing takes the air deeper into the lungs. Nasal breathing slows down your breathing, nasal breathing increases oxygen uptake in the blood by about 10% now, most people won’t do physical exercise with their mouth closed because they feel that are not getting enough air. They fear to suffocate, this is just at the outset, keep training with your mouth closed. Do it for 10 to 12 weeks. Do all of your physical training with your mouth closed. Your fitness level will surpass anything beyond what you’ve done before and you’re going to measure your bolt’s score and use that as an indicator of whether you’re making progress or not.

Matt :                                  11:13                    So to sort of summarize a bit of that, if people use that very simple test that you use called the bolt score, where you take a normal nasal breath in a normal nasal breath out, you pinch the nose and then it’s about how long it is until you get the urge to take a breath. First. Definite desire your time in that, um, as a, as a measure. So I did mine a while ago, Patrick mine came in at 23 seconds, so I was on the, uh, I was just on the verge, on the verge, hopefully, uh, now with now with taping up at night and stuff, I’ll, uh, I’ll see a change in that and in my training as well. Um, so you, you, you take that score and then obviously it’s something that gives you an to retest further down the line. Now exercise is obviously a tough place to start potentially with getting people to do nasal breathing. Um, and I know that when I’ve heard you talk before, Patrick, you, you talk about maximizing nasal breathing during sleep and, and, and just during the day. So that’s probably a better place to start in terms of, um, there’s less urge to use your mouth. Um, can you talk to us a little bit about, you know, introducing things to help people, nasal breathe and start making that a behavior or a habit and something that we can change? Sure.

Patrick:                               12:29                    Well, when you look at breathing Matt, we should look at a number of dimensions. I’ll give you a couple of examples and I think this is where breathing is really being overlooked and you know, just been mistakes made. Breathing is not just about the biomechanics. I spoke about the biomechanic stair die from madic breathing. If you go to a local yoga studio, the emphasis is probably on the biomechanics brethers and your diaphragm not very much an emphasis generally on nasal breathing. Biochemistry isn’t considered in cadences isn’t considered, well, when I look at somebody’s breathing, I want to consider three things. Number one is I want to look at the biochemistry. I want to look at what’s the volume of air that that person is breathing, which in turn determines, you know, is influenced by chemo sensitivity of the body to the buildup of carbon dioxide and quite simple terms.

Patrick:                               13:22                    The biochemistry relates to the CO2 pressure in the blood. If we are breathing too hard, blood vessels constrict and oxygen isn’t released so readily and the biochemistry is very important to consider because ultimately that’s what’s going to consider how hard or breathless are you during physical exercise? So you, as you know, you say it’s, yeah, it’s normal. Don’t necessarily start a physical exercise. I’d probably say start also with physical exercise, but also during the day and also during sleep. The second dimension that we need to look at with breathing is to buy a mechanics. So we need to breathe using the diaphragm. But all too often when we hear somebody breathing using the diaphragm, they breathe more air but if you breathe more air? You’re now sacrificing your biochemistry. So we need to consider if we are activating the diaphragm and by the way, we can only do that by nasal breathing, not by mouth.

Patrick:                               14:23                    Mouth breathing is directly linked with the upper chest. Nose breathing is linked with diamphramatic breathing. So another thing is individuals who are teaching diamphramatic breathing but they never talk about nasal breathing. And I’m not just talking about nasal breathing for the few minutes in studio, I’m talking about nose breathing 24 seven with the exception of a few mouth breaths here and there. Okay. They, you know, we have to be, we’re not, we’re not Nazis. And then the third aspect of it is cadence. The rispiratory rate that we breathe can have a huge impact at the restoration of the normal autonomic nervous system. For example, there’s pressure receptors in the blood vessels called barrow receptors and individuals who are not well, whether they have post traumatic stress disorder, high anxiety, depression, high stress levels, chronic fatigue, fibromyalgia, COPD asthma irritable bowel syndrome and a host of different conditions.

Patrick:                               15:18                    They have poor sensitivity of the pressure receptors in the blood vessels. And this in turn reduces heart rate variability respiratory. So we also need to look at the cadence of breathing and the optimal cadence to stimulate the baroreceptors to help the body to recover from stress is six breaths per minute. So on a functional breathing basis, people come in, I go through biochemistry with them, I have them slow down, their breathing to generate air hunger. That’s the change to biochemistry. I also go through biomechanics, them diaphragmatically breathing in order that they’re harnessing and using their diaphragm. And then we do a cadence breathing to help restore functioning of our autonomic nervous system. And here is where it’s coming back to breathing. Who is doing all three? You know too much there’s an emphasis on doing one, but sacrificing the other.

Patrick:                               16:14                    And even if you’re doing cadence breathing, you can’t sacrifice diaphragmatic breathing and you can’t sacrifice biochemistry. So it’s like the best description that I think of as it’s like a three legged stool. If one of the legs is not there, the stool will fall. But breathing falls the same way. If we’re not looking at the three legs of breathing, we’re not utilizing breathing properly. So coming back to your question, taping of the mouth. 20 years ago I started taping my mouth. It was the first night I had a decent night’s sleep all the way through my school, secondary school. It was a disaster for me. I had no concentration, hated school. I did a degree. I really worked hard. I’m pretty driven. I worked 10-12 hours a day studying got my points got into university, got my degree, a lot of work, a lot of work.

Patrick:                               17:08                    Not that I was stupid, but just did that. I didn’t have concentration because you can’t have good concentration unless you have good sleep. Sleep is a pillar. How can you perform in sports in corporate world, in family life? How can you have a calm mind unless you have quality of sleep? You cannot have quality of sleep unless the mouth is closed. So in any event, I switched to nasal breathing back in about 1998 and it was tough going. I was feeling totally suffocated. Breathing, through my nose because I’d spent the previous 20 years mouth breathing, but I taped up my mouth at night and I use breathe right strips to open up nose based on the coffin maneuver and I woke up the next morning and I couldn’t believe it. You know, it was, it was incredible the difference it made to my sleep because I used to wake up like a hangover, you know, waking up groggy, not able to concentrate, irritable, fatigued, no energy throughout today and I’m 46 years of age now.

Patrick:                               18:10                    My concentration now is measurably better than what it was when I was 20 years of age and it shouldn’t be necessarily that way. Anybody with kids, we have to get them nose breathing. And this is not just airy fairy new science. There’s a huge amount of research on the benefits of nasal breathing for sleep driven by one doctor and his name is Dr Christian Gamano French doctor from Stanford. Now, sadly, he died about three months ago, but he discovered the condition of obstructive sleep apnoea well he didn’t discover it was always around, but he coined the term he named the disease obstructive sleep apnea, which is a sleep disorder. And he also did developed the main measure in far diapnoea hypopnea index. And he talks about the critical importance of restoring nasal breathing during sleep. Now, yeah, I get it. Don’t be on your mobile phone late at night.

Patrick:                               19:09                    Don’t be on your laptop. Avoid blue light. Don’t be drinking alcohol. All of this stuff, it’s all good. But the elephant in the room is breathing through the nose because if you’re having your mouth open, your airway is restricted. The resistance to your breathing is higher, you’re more likely to snore, you’re more likely to stop breathing and you’ll wake up feeling unrefreshed. So again, you think of the, the population who have breathing pattern disorders, 30% of the asthma population in the literature, I would say it’s much more any person with asthma, they don’t have normal breathing because the condition is feeding into poor breathing patterns. Because when the airways are constricting, you feel that you’re not getting enough air, and as a result you breathe harder. This in turn is causing cooling and drying of the airway walls, which in turn is feeding into constriction or narrowing of the airways, which in turn is generating symptoms of coughing and wheezing, which in turn is disrupting, breathing, etc.

Patrick:                               20:08                    Next group of people who are very prone to breathing pattern disorders. Anyone with anxiety? Now we’re talking about 80% so you think of individuals with anxiety. How do they breathe? They breathe fast and they breathe shallow. Maybe somebody will say, well, they’re breathing that way because of their anxiety. That’s correct. Anxiety makes us breathe fast and shallow, but fast and shallow breathing also feeds into anxiety. That’s where we have to break the pattern. You can never have a calm mind, never if your breathing is fast and shallow because as long as your breathing is fast and shallow, you’re in a fight or flight response. And also we don’t have good sleep because we’re mouth breathing, fast breathing, shallow breathing. So here you have somebody with agitation of the mind. They’re feeling anxious. They’re doing cognitive behavioral therapy, which is all very well, but who is talking about there breathing and did not this nonsense.

Patrick:                               21:07                    Take a deep breath. The greatest load of crap that was ever discussed, put out there because it’s not based on it’s gone. Common knowledge, it makes absolutely no sense unless you take a true deep breath, which is a diaphragm breath, It’s light and it’s quiet, so the person with anxiety, change your breathing patterns, improve your sleep. You know, if you, if you don’t have good sleep quality, you’re not have having a calm mind and if you don’t have a calm mind, you’re not going to have good sleep quality because if the mind is agitated, you can’t achieve a deep sleep. Any of us, if we have a very stressed day, you go to sleep that night and you can’t sleep properly because you’re twisting and turning because the mind is too active. We need to be able to completely switch off and we can completely switch off through the breath.

Patrick:                               22:02                    You know, like I can go on and on, but I think it’s one of the most wonderful things we can do is bring our attention onto our breathing and even just in terms of concentration, like I too poor breathing patterns and an agitated mind, inability to concentrate. I’d be looking at something, I would be reading it, but my attention wouldn’t be on what I was doing because my attention was stuck in my head. So for 20 years I was living primarily stuck in my head as opposed to connecting with everything that’s around me and for those of us who are in the habit of excessive and repetitive and incessant thinking that we can’t switch off to mind if you cannot switch off to mind, we’re more prone to stress. We’re more prone to anxiety, we’re more prone to unhappiness, we’re not able to focus and we’re not able to concentrate.

Patrick:                               22:54                    How can you concentrate if the mind is totally distract by repetitive thinking because concentration is the ability to hold her attention on a subject for a period of time without distraction. Now personal trainers, you’re not just training the body, you’re also training the mind. It’s not just about going through the emotions, it’s about taking your attention out of the mind, running with every cell of the body, exercising with every cell of the body, and this is fundamentally important than it’s coming back to because the quality of our life, I would say in terms of my work is three pillars. One is emotions, agitation of the mind. The second is sleep, and the third is breathing and breathing connects with sleep. Sleep connects with the emotions, emotions connect with breathing. Breathing connects with emotions and sleep and breathing and emotions are all interconnected and that’s where I want to go with this to open it out and that’s only addressing functional breathing. We haven’t even talked about breath holding as a stressor

Matt :                                  24:02                    Even just in that few minutes there, Patrick, I mean, hopefully you’ve opened everyone’s eyes to just how bigger a bigger deal this actually is in terms of getting people breathing properly. We all breathe, but we need to do it better. We need to do it properly. We need to make sure that it’s functional. I know that part of one of the things that you talked about that that’s going to stand out to our audience, Patrick, is the idea of helping children with this, especially in health and fitness. We’re very keen on let’s start at a young age and let’s make this a habit. You know we like to get clients children’s involved and things like that. Like let’s start young. I’ve got two and a half year old and there are definitely times where I would love to tape his mouth shut. Talk to us about how, how we actually do this with children. How does this, cause I know you’ve got certain parameters and things that you like to follow and there’s ways of doing this.

Patrick:                               24:51                    Yeah, typically we teach kids our, our, our children’s program is free. It’s online. If you go to buteykoclinic.com I’m not sure what link you’ll have to click, but basically buteykoclinic.com look for the children’s program and you can get access to all of the videos for children completely free. So that’s number one.

Matt :                                  25:12                    Brilliant. We’ll link to that in the show notes and make sure that people can find it.

Patrick:                               25:16                    Okay, that’s, that’s a good idea. Number two is not to tape children’s mouths, but we are introducing a new tape. Listen, we have been encouraging taping of the mouth for many years but it’s not without risk and we have health care professionals who are using it and you know it can get people well into trouble and of course for the child we don’t want a child getting sick during sleep with tape mouth. That would be terrible. You know it hasn’t happened, touch wood yet, that we are aware of. We’re introducing a new tape called myo tape, and myo tape is going to be a tape that surrounds the lips to bring the lips together. We need to get children breathe in through the nose and up until now, taping was the only solution with myo tape. It’s going to be different because it’s not going to cover the mouth and it’s elastic and it’s based in kinesio tape that it’s bringing the lips together with light elastic tension.

Patrick:                               26:11                    To give you a few statistics. Matt and your, your listeners can research this. 40% of children. There was a study in Stratford upon Avon, if for any reason, one, I think it was Karen Barnack Bon UCK is the researcher and I went on for eight years and the research is 11,000 children, 11,000 kids, children who are mouth breathing and sleep problems. They had 40% the risk of learning difficulties, special needs. That’s what it’s about. I can give you other stats. If a child is snoring by the age of eight and un-treated, they have a 80% percent chance that they will have a 20% reduction permanent reduction to their mental capacity. That’s what we’re talking about. These kids, their brains are getting fried as a result of sleep disorder breathing. And here’s the unfortunate thing, the medical community, haven’t woken up to dental community with the exception of a few enlightened dentists haven’t woken up and everybody is asleep it.

Patrick:                               27:20                    And yet it’s in the literature. And I am a simple lay guy. You know an individual who has been looking at this for 20 years wondering what on earth is going on, why, why you have the medical community failed in addressing breathing and sleep disorder breathing in kids and they have failed abysmally. They’ve really, really screwed this one up. We know up to 50% of study children persistently mouth breathe 50% and what’s more, you’ve got some great people in the UK, Dr John Mew, Dr Mike Mew, you’ve got range of individuals who have been pushing this agenda and at the same time the British orthadontics society had been trying to silence them all mouth breathing children develop crooked teeth because the shape of the mouth is the shape of the tongue and if the mouth is closed and if the tongue is resting in the roof of the mouth, it helps to develop the top jaw.

Patrick:                               28:22                    It helps to ensure a wide facial structure with a good airway and development of the lower 50% of the face mouth breathers. I was a mouth breather. My airways are totally compromised. I could never be an athlete because I don’t want to have the airway sufficient to carry air into the lungs. If your listeners are outside of the UK, look at the work of Dr. William Hang United States. There’s many, many, dentists, Kevin Boyd and Chicago. Just many dentists who understand this and who get it and find are looking at teeth that are not just about straightening teeth because it’s about the airway. It’s about the development of the face, a functional orthodontist. When they look at a child, the teeth getting straight is down the list of priorities. If, if the shape, if the face can be guided to grow the way it should grow.

Patrick:                               29:22                    So if the mouth is closed with the child and if the tongue is resting in the roof of the mouth and if the orthodontist is putting gentle appliances to develop the maxilla at the top jaw and the mandible of the child, now the face grows correctly and when the face grows correctly, the teeth are straight. Straight teeth don’t create a good looking face. A good looking face creates straight teeth. The dental industry. This has been debated since 1909 if you’re looking into dental the cosmos, and you will see that dentists have been writing about this for 110 years, and Yesh the British dental council, the British orphodontics society, the Irish dental council, the Irish orthodontic societies and orthodontic societies worldwide have gone into this academic debate and completely forgot about the children who have been left remaining with their mouth’s open. So common sense, this is the nose serves physiological functions in the human body and for human beings.

Patrick:                               30:34                    We are the only species on earth with the exception of a dog that don’t know what our nose is for, how many of your listeners wake up in a dry mouth in the morning? Have many of them do their physical exercise are, or you bring in a new client and a new client is puffing and panting. They’re about to keel over their breathing is so hard. Get the new client breathing through the nose. Get your existing clients breathing through the nose because breathing should be slow. It should be light and it should be deep.

Matt :                                  31:07                    So in terms of where we’re at now, then Patrick with breathe in statistics and things appearing to be extremely poor, what do you think has led us to this point? How have we gone from a species that was nasal breathers to now be in what sounds like predominantly mouth breathers like is it, is it the world that we’re living in is how much of it is like lifestyle and nutrition and things like that? Where do these things tie into this sort of stuff?

Patrick:                               31:34                    I think there’s a number of factors. I don’t think there’s one. One factor that has caused us a few different things. One is tongue tie. If a child is tongue-tied, the child is not able to breastfeed adequately and breastfeeding isn’t just for nutrition but it’s actually about manipulation of the muscles of the face which is necessary for cranial facial growth. We need to develop the muscles of the face that we have good muscle tone and it’s the muscles of the face which are helping to ensure nasal breathing and it’s nasal breathing, which has happened to ensure the growth of the face with the tongue and the roof. The mouth is if the child is tongue-tied, child can get the tongue up into the roof of the mouth. Second one is dummies pacifiers. For every one year use of a pacifier or a dummy, it increases the risk of map reading by 25% now of course a child or young child is going to use it a dummy for a little bit of time.

Patrick:                               32:28                    That’s fine because if they get upset it gives them some comfort and if you don’t give them a dummy, they’re going to stick to her two years in anyway. So either way they’re going to get something in there, but what I would say is limit it. Just be aware of the effect of the dummy. The child is sucking a dummy and sucking everything inwards, and it’s also contributing to narrow facial structure. The thing about an narrow facial structure, there’s not enough room for the tongue. And if there’s not enough room for the tongue, it’s falling into the throat. I’ll give you an example. Google your Prince, the Royal family, Prince William and Kate Middleton. And look at the cranial facial structures of the two of them. When Williams smiles count how many teeth, can you see? And when Kate smiles count how many teeth can you see?

Patrick:                               33:26                    With William you will see about 6 teeth is a really narrow jaw, probably because he had orthodontics and some stupid orthodontists removed two or four teeth from William instead of gently expanding his jaws. So the orthodontist and, you know the Royal family, they’re going to have access to the best orthodontics who is totally screwed up his mouth. He doesn’t have enough room for his tongue. And this is going to increase the risk of sleep disorder breathing. Look at Kate Middleton and she’s a beauty. She’s beautiful looking. And when you look at the amount of teeth you see, she’s got a really nice wide facial structure. When she smiles, you can see about 10 teeth, 12 teeth. And it’s not just that she’s beautiful, but she’s functionally good airway. Plenty of room in the mouth for her tongue. So well done to William. He chose well there.

Matt & Patrick:                 34:24                    Hopefully he’s passed onto his kids. Well I would hope so. But you know, here’s the, here’s the instance, like when is the orthodontic profession going to start waking up to this? Like we see kids coming in. What I say to kids, I’m seeing 20 year olds coming in and they have sleep apnea. And I asked them, well, when did it start? Oh, it started when my parents saved up so much money to get orthodontics, to remove, teeth, to attract my jaws too. And it absolutely destroyed the people. So they have straight teeth but they have a compromised face and a compromised airway. Anybody who’s looking at orthodontics, no extractions, no retraction. And if you’re orthondotists says wait until you’re 12 or 13 and then come in to me, go look for an orthodontist who does early intervention, 12 or 13 the faces already grown, it’s too late.

Patrick & Matt:                 35:20                    This shouldn’t be about the easy way out, you know, hand over three or 4,000 pounds, pull out, teeth and throw on a pair of brackets, set of brackets. This should be about developing the child’s face and ensuring those are breathing. Kind of feel like I’m lecturing here this morning, but I wanted to get my point across, you know, because this is stuff that I should have heard when I was a kid. Nobody told me. Sometimes for these things to change it, we have to give people the knowledge to go and ask the questions and things, don’t we in ups, you know, if they’ve got to go and find the professionals themselves and know what to ask, then that’s, that’s probably which professionals Matt because you’ll have plenty professional saying what I’m saying is a lot of crap. Yep. And then you have plenty of professionals saying that, yes, this is correct because we have two schools of thought and orthodontistry and one school is in total conflict to the other.

Patrick:                               36:10                    One school is saying that the teeth are crooked, the teeth are crooked because the child is after inheriting dad’s big teeth and mum’s small jawand the other school is saying the teeth are crooked because the jaws too small because there’s not enough room in the mouth for the teeth. So the second school is saying let’s widen the jaw and the first school is saying, let’s take out teeth. Well, widen the jar first. You’ve got 32 teeth, hold on to them. So in terms of all the lifestyle factors, Patrick, are there anything, so you talked about when kids are young, they’re, you know, using pacifiers, breastfeed and things like that. Does any of our actual nutritional habits or anything else that come into play at all? Talk to us a little bit about that. I think nutrition is probably a big one. There’s a book called nutrition and physical degeneration written by a doctor, Western price back in 1938 it’s probably a founding book on nutrition.

Patrick:                               37:08                    Basically he went around various civilizations. He went to Mary’s esomos Swiss people. They went to Gaelic people off the Hubbard the islands. Page 55 of that book, he talks about children, first-generation children. So on the hebrides you can imagine that they were eating very traditional food for many years, thousands and thousands of years. And our traditional food was oatmeal, porridge and fish. That was it. And the people had perfect development of their jaws. And then commerce started coming to the islands too. The hebrides so commerce started bringing chocolate and marmalade and sugar and all of the stuff that’s in our supermarkets. Within one generation children became mouth breathers and had narrow facial structures. Overcrowding of teeth. So what happened very, very quickly, my parents had really wide facial structures and no overcrowding of teeth and all of the kids have overcrowding of teeth. Every one of us had crooked teeth. So crooked teeth is not about genetics. It’s really about the environment meeting with the genes to say to the child has got crooked teeth because of genetically, how come they’ve had straight teeth for hundreds of thousands of years? What’s happened to the environment in the last 50 hundered years? And the first documented cases of crooked teeth but 400 years ago. So if you go to a natural history museum and

Patrick:                               38:36                    you look at skulls there, none of the skulls have crooked teeth like our ancestors didn’t have crooked teeth. So clearly we are doing something incorrect. Look at the work of Mike Mew. Dr Mike mew is an orthodontist who is a good friend and he’s based in purly in London and he’s been talking about this for decades and his father has been talking about it for decades. They know, you know and other professionals know it as well that yeah. Is it down to nutrition? It could be do you have a food? Like what are we eating? What are we giving our kids to eat? Like what did our ancestors eat? Probably they had a bone and the child would have been handed a bone with meat on it, the child was there chewing away at tough meat. Developing the face. What are our kids eating? Well, not mine.

Patrick & Matt:                 39:22                    at least I hope, not under my reign, our kids are eating McDonald’s and burger King, pre chewed foods. That doesn’t cause any development of the face. So the best thing that we could give our kids is probably a good rib steak that they’d have to chew it leather steak to develop the jaws. You know, I’m kind of kidding and not but. You kind of get my point. Yep. Soft food is not good hard food where we buy, we have to really put in some effort. That’s good. It’s like anything isn’t it? you’ve got to develop muscles, you’ve got to develop the underlying structure. You know, we understand that from a, from in our profession anyway, we understand that from most of the body that that has a place and it’s, it’s just that we’ve not considered it

Matt :                                  40:06                    when it comes to his mouth and the jaw. Yeah.

Matt :                                  40:09                    Going back full circle with this then Patrick and tie in back into actually developing good breathing habits. I know that you have certain techniques that you like to use in breathe holds and things like that. You’ve got a book about the whole subject called the oxygen advantage. So can you tell us a little bit about what some of those techniques are and how these things work and hopefully people will go and pick up a copy of that book. It’s an awesome book for understanding some of this stuff, so just give us an insight into into some of those things.

Patrick:                               40:36                    Yeah, there’s two pillars to it. One is one is improving a functional breathing and that’s the foundation of it. And with that, your breathing should be in and out through the nose. There’s two tests. One is the bolt score, which we spoke about and the other is a maximum breathlessness test. Now, don’t do the maximum breathlessness test if you’re pregnant or if you have high blood pressure or serious medical conditions. You’ll get the maximum breathlessness test on the homepage of oxygen advantage.com there’s a video there. You’ll see it. I’ll describe it. Take a normal breath in through your nose, a normal breath out through your nose. Pinch your nose, hold your nose, start walking, holding your breathout. How many paces can you hold your breathe for at the very end when it’s pretty tough, let go, but breathe in through your nose. It’s a maximum breathlessness test.

Patrick:                               41:26                    The objective is to try and achieve 80 paces on one breathe hold. Now that exercise will also open up your nose and you could also use that exercise to simulate altitude training. So in a way, you know we’ve got other exercises, but this is just a simple way to start. If you were to do that exercise, do it six times and have a minutes rest between each and the whole premise of breath holding on the exhalation is to drop your blood oxygen saturation. To give you an example, people do high intensity interval training to stimulate anaerobic glycolysis. If you sprint with your mouth closed, your blood oxygen saturation will drop down to about 93/92% but if you do breather holding, your blood oxygen saturation will drop down well into the 80’s. So we create severe hypoxia doing what we’re doing. We really do generate and simulate altitude training.

Patrick:                               42:21                    We also use a product called sports mask with physical exercise and it’s a mask that I did well. I designed it, but of course there’s competitors, just trending masks out there, but we developed it not necessarily to simulate altitude training but to pull carbon dioxide. Now, just two options. If you’d go for a run with your mouth closed, it’s tough, but that’s good for you to do. Look at a paper by George Dallum, D a. L. L a M just published last year. He’s a fairly well known triathlete in the United States, but he’s also an academic and he got 10 10 recreational athletes. He got them to switch to nose breathing during physical exercise for six months and then he measured our performance. So here it was Matt. They were able to achieve 100% of their work rate intensity breathing through the nose as breathing through the mouth.

Patrick:                               43:17                    What they had 22% less breathing. That’s a 22% economy. Yup. They’re breathing. The respiratory rate with nasal breathing was 39 breaths per minute with mouth breathing was 49 breaths per minute. The carbon dioxide in the blood, which mouth breathing was 40 millimeters of mercury pressure with nasal breathing was 44 the fraction of expired oxygen was a lot less with nasal breathing. In other words, that oxygen was delivered to the working muscles. Now we can delay fatigue, delay lactic acid, increase the buffering capacity, open up the airways, reduce the psychological perception of breathlessness because when we’re doing the likes of breathe holding and we do some sprinting with breathe holding and different exercises, it’s tough. It’s very, very tough. And the breathlessness is well beyond anything that you would achieve during a sprint, however you recover so much quicker. So we would put people through sprinting with breathe holding and then recover within about two breathes.

Patrick:                               44:23                    And you can imagine the adaptations that we’re doing there. But you know in a very simple level, with your clients breathing through the nose, during physical exercise and tell them, let their nose dictate the intensity of the physical exercise they’ll be breathing slower and deeper. They’ll be increasing oxygen uptake in the blood. They will be increasing oxygen delivery to the tissues their recovery will be better post exercise, breathing through the nose, during sleep during the day and bring in some breathe holding and do the maximum breathlessness test as well. Especially if anybody has hay fever, nasal congestion. You can open up your nose and five minutes holding your breath.

Matt :                                  45:05                    The nose opening exercise. I’ve actually used a few times myself and I found that really, really useful and one of the things we haven’t quite touched on yet in terms of the mechanics is I know that when you explained this in the book is one of the, one of the things that we think helps with that is the buildup of nitric oxide in the, in the nasal cavity. I know it’s not fully understood yet what it’s main roles are and things like that, but just just get the listeners a little taste of of what we think might be going on there with that and how that’s helping like basal dilate and things like that.

Patrick:                               45:36                    Nitric oxide was discovered on the exhale breath of the human in 1991 so it’s a relatively recent discovery. So when you breathe through your nose, you pick up nitric oxide and you’re carrying that nitric oxide Laden air into your lungs. A nitric oxide helps to redistribute the blood, throughout the lungs. And this improves gas exchange. So nasal breathers are better oxygenated. Nitric oxide also sterilizes the air and it’s a broncodilator. So if you think of people would exercise and have asthma there’s quite a big population in the UK and in Ireland it’s about 10% of our population have asthma. So it’s fairly, I think it’s about 5 million people in the UK and we’ve close to 500,000 people here. And the vast majority of people with asthma or exercise and just asthma are just somebody who is exercise and just prompt constriction. They were my breathe and they will breathe hard unless they mouth breathe and breathe hard.

Patrick:                               46:35                    Moisture is sucked out of the airways and it causes the airways to narrow. Well, nitric oxide is a Bronco dilator, so when you breathe through your nose, your nose moistens and warms the air on the breath coming into the body. And as a result you’ve got less trauma to the lungs and nitric oxide also helps to sterilize the air in terms of reducing the onset of chest infections. Now the other thing matters. Breathe in through your nose but also breathe out through your nose because as you breathe in through your nose, the nose is warmed and moistened the incoming air. But as you breathe out through the nose, the nose traps that heat and moisture to keep it in the body. Mouth breathing causes 42% greater water loss. I remember I was listening yesterday, some personal trainer was talking about working with his clients and you’re saying that the clients start off, they often complain that their mouth is so dry.

Patrick:                               47:29                    during physical exercise, of course, he’s not aware of the importance of nasal breathing, but of course your mouth does dry during physical exercise because you’re losing all of that moisture and a dry mouth, You’re increasing the risk of dental cavities, gum disease, bad breath, so you’re, it’s trauma to the airways because the airways aren’t able to cope. You know your mouth isn’t doing the conditioning. Your mouth isn’t for breathing. Full stop, go look at Neanderthals. If they’re a distant, distant ancestors and researchers discovered last year that these guys had really wide nasal passages. Why not just for breathing during sitting but for breathing during, physical exercise, the race horse, the cheetah, the fastest animals on earth. You don’t see them going around with their mouths hanging open and our tongues out like a dog. I was, it’s kind of interesting. I was in Copenhagen about six months ago and I was giving a course and there was a mini Mark or a half Martin, uh, just down the street and walk down and they said, okay, I’m going to bring that on my phone.

Patrick:                               48:36                    I just started taking snaps to see how many people are mouth breathing. Okay. I didn’t take any photos as this. Everybody was mouth breathing, there wasn’t, it didn’t see one person passed me with their mouth closed. Why? Why has this not got the attention? Because I think we want instant gratification. We want the quick fix as opposed to, you know, go roam with your mouth open there. Yeah. It deprive your body of oxygen, reduce the oxygen uptake in the blood, traumatize your airways, don’t use your diaphragm because you’re not going to be using it as effectively with mouth breathing as opposed to saying to somebody, yeah, this is going to be tough. This is going to add an extra load onto you. You breathe through your nose, you’re going to feel an extra load. This is going to strengthen your breathing muscles. This is going to increase oxygen uptake, improve recovery, increase oxygen delivery. You’ll stay areobic for longer. You keep doing it and your fitness levels were surpass anything that you had before.

Matt :                                  49:35                    So as people come into terms with the fact that they might have to take a small step backwards to then go a big leap forwards in terms of their actual physical performance.

Patrick:                               49:44                    Yeah, and the other thing is just to warn them to bring a tissue because your nose will run like hell. So bring a hanky with you but that’s normal. It dries up.

Matt:                                   49:53                    The final sort of area I wanted to touch on here, Patrick, in terms of of all of the sort of the, the many facets to breathe in this way and the health implications and sleep and stuff like that is to me there seems to, and you’ve already touched on it already, it seems to link in really nicely with a huge topic at the minute in terms of like just general mental health and wellbeing and you know, managing stress and coping and you mentioned it before about anxiety and things like that. How are you seeing people’s change in breath actually impacts their mental health and their wellness? Cause obviously

Matt & Patrick:                 50:28                    we’ve talked about biomechanics and things like that and performance. If we looked at it from a mental standpoint to huge, just as nose breathing is overlooked in sports. Yeah, it’s been overlooked in mental health. The problem we’ve got here with a breathe in Patrick is, is a, it’s not like being able to sell a medication is it and make some money off the back of it. It’s, it’s very, very true. Like, not, I’m not exaggerating, but I’ve got an email in yesterday from a guy addicted to opioids in the United States and nasal breathing. He said the differences that it has made to his mental health, and this is the guy he was after coming off a drug addiction. We have a drug addiction counselor and one of the centers in Canada, like in terms of an oxygen advantage, we’re in about 25 different countries and then Buteyko clinic, we’re in about 50 we have people, psychologists and doctors, and we have orthodontists as well, different disciplines who are trained bringing breathing into their professions.

Matt :                                  51:28                    So I’m one of those guys and addiction. So he’s working with fatter ans et cetera. But what would I say to anybody? I’d say really start paying attention to your breath and slowing it down and breathing through the nose. A few things. One is your sleep is better. Number two really slow down the speed of the breath coming into your nose. And then at the top of the breath, take a really relaxed and slow, gentle breath. Focus on slowing down to speed of the breath coming into the nose at the top of the breathe. Bring a total feeling of relaxation to the body and allow relaxed and gentle breath out. The objective is that your breathing volume is less than what it was before you started. You’re feel air hunger. Then put your hands either side of your lower two ribs. And as you breathe in, very slowly in likely breathe into the lower two ribs.

Patrick:                               52:19                    And as you breathe out, allow the two lower ribs move inwards. And as you’re breathing, feel lateral expansion of the lower two ribs. And as you breathe out your lateral contraction, you don’t have to take a big breath to have a deep breath the diaphragm is very important for the emotions. Italian doctor Bardoni, he talked about to diaphragm as not just the breathing muscle, but it’s connected to the emotions. The other thing that’s connected to the emotions, is the speed of our breathing. If you Google search Stanford slow breathing researchers in March of 2017 they published that they had identified a new structure in the brain and the locus Corollas, and this structure is spying on your breathing and if you breathe fast, this structure would relay signals of agitation to the rest of the brain. And if you’ll breathe slowly, this structure will relay signals of calm to the rest of the brain.

Patrick:                               53:20                    So I think in terms of mental health, true the brat by on your brewery, then you’re taking your attention out of the mind onto the breath. That in itself is a meditation. Don’t get frustrated with it because of course your mind is going to wander when it wanders. Bring it back again. The mind wanders when it wanders, bring it back. The objective is not to achieve a quiet mind. The Objective is simply just spend a little time focusing on your breathing. So play with it so you have your attention on the breath this is helping to quite in the mind at the same time that your attention is on your breathing. Slow down your breathing really lightly and breathe using your diaphragm and practice that for a few minutes here, few minutes there. If you’re really wanting to make good progress, do it for five minutes, six times a day, just five minutes, six times a day and start with that. Don’t have your mouth open, don’t breathe fast and shallow as long as you breathe fast and shallow, the mind is agitated and sleep is impacted.

Matt :                                  54:28                    Patrick you’ve covered an amazing amount of content and useful information in a short amount of time there. So I wanted to thank you for that before we finish off today cause I’m very wary of protecting your time and that as well and keeping a listener’s attention. We’ve mentioned a few links along the way and I’ll make sure we uh, we get those links on the show notes page. Give the listeners an idea of where they can find you online or any stuff that they can get involved in if they are interested in it. We’ve got PTs listening, we’ve got people that just are involved in physical exercise. Give us an idea of where they can go and find out more about this and get involved with you and your work.

Patrick:                               55:03                    Sure. There’s two kinds of elements to it. For the fitness professional, it’s oxygen@advantage.com. So oxygen advantage.com would be the main website there. And then people dentistry, sleep disorder breathing respiratory, that’s Buteyko clinic.com. So I’ve kind of kept them separate because you know, just going to be different exercises for a fitness person as opposed to a person who’s coming in unwell, it’s all about improving resilience and it’s all about optimizing, breathing efficiency, um, just lots of stuff there. Just free videos, different things, put it into practice, nothing to lose.

Matt :                                  55:42                    And then as I mentioned earlier as well, you’ve got the, uh, the oxygen advantage book as well that people can pick up. And I’d recommend everyone, have a read of that cause that’ll be very useful for them, especially the, the actual techniques and that, that you cover in there. It’s easy to, uh, to implement. Thank you very much for your time today, Patrick. It’s been an absolute pleasure having you on board. Hopefully we’ve helped you with your passionate journey of trying to spread this message to more people, I know there’s plenty of people that will be here in this for the first time so we’re going to try and make sure we spread it far and wide and implement it with the people we help. It’s an important movement that you are creating here.

Patrick:                               56:15                    Great. Thanks very much. Matt. Happy to join you on this journey

Matt :                                  56:27                    So there you have it, an unbelievably interesting conversation with Patrick McKeown. I was quite happy to let him just go on and tell us what he needed to tell us about this specific aspects of health and fitness. It was a conversation that I haven’t really heard in in many fitness podcasts before and I wanted to make sure that he got the time to go through all the different aspects of what he wanted to cover today, and this is an episode in particular where I would really, really appreciate your feedback in terms of what you thought about this subject because it’s something that I believe we probably should start paying a bit more attention to. It definitely seems like this is an area where

Matt :                                  57:02                    if we all spend a little bit of time and energy focusing on this, we could get a massive amount of return on our investment. So please make sure that you reach out on social media or by the website and let me know what your thoughts are. This episode is also great if you can tag the oxygen advantage in there as well and let Patrick know that it’s been useful for you to listen to. If you want, you can grab the full show notes over mattrobinson.blog/034 that’s for episode 34 you will have all the show notes over there, and you will also have the opportunity to join the weekly mailing list to make sure that you get notified when the next episode goes live and get a secret little resource that you won’t find in the podcast. Episodes or in

Matt :                                  57:46                    the show notes. They’ll be in there for subscribers only. Hope you enjoyed that episode with Patrick. That link again is mattrobinson.blog/034 until next time, take care of yourself and we will see you very, very soon with some more fantastic guests. Take care

How One Small Change In Your Breathing Can Completely Change Your Health & Fitness

Before this interview, I already knew about Patrick McKeown and the work he does. I’d even read his book, The Oxygen Advantage

Despite that, what he had to say, the facts he had to share and the case studies he had talked about in this interview completely blew my mind.

Breathing is something that everyone does (hopefully!)

 But when did we last stop to think about if we are breathing properly? In fact, when were we ever taught how to breath properly?

If you ever wake up in the morning with a dry mouth, a stuffy nose or just feeling lethargic and unrested – the chances are that you are a mouth breather and need to re-asses the way in which you breathe during rest.

In doing so, you could potentially unlock a whole new level of health, wellness and fitness for yourself. 

Links & Resources

Patrick’s Book – The Oxygen Advantage

The Oxygen Advantage Website

Buteyko Clinic

Free Breathing Course for Children

Dallam’s Study – Effects of Nasal Breathing Versus Oral Breathing on Vo2 Max

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